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Seasickness can ruin a day out on the water, but on ocean passages sustained seasickness can compromise the safety of the crew, even the boat. In this article experienced cruising instructors John and Amanda Neal detail critical steps to avoiding and treating seasickness.

Seasickness results from sensory conflict and/or stress, both of which produce histamine. Nausea results when histamine reaches the brain. Some people are more susceptible than others, but everyone can become seasick, given the right conditions.

Seasickness can occur anytime afloat, but here are some conditions that can increase susceptibility: feeling anxious or fearful, change of motion, navigating or reading, heavy weather, pitching or rolling motion of the vessel, chop, fatigue, smells or eating.

When sailing in local waters, seasickness goes away once land is reached. However, on coastal or offshore passages of more than 24 hours, preventing or effectively treating seasickness becomes a health and safety issue as left untreated continual seasickness results in incapacitation.  

The responsibility for the safety of the boat doesn’t go away if you’re seasick. A safe watch for other vessels, the course and the weather must be maintained. It should be the focus and responsibility of everyone on board to help their seasick crew members recover as quickly as possible.

Prevention before departure

Avoid alcohol, coffee, colas, alcohol and fatty foods for several days, increasing your water intake to at least two liters per day. Start taking appropriate medication 24 hours before departure and catch up on sleep. Sleep removes histamine from the bloodstream. Prepare everything before departure to minimize time below decks once underway: have quick meals ready to go, make up bunks, organize navigation and have clothes laid out.

Once underway: maintain hydration and blood sugar by drinking Emergen-C or a similar vitamin-mineral mix containing potassium and electrolyte replacement minerals, plus snacking on fruit (bananas, rich in potassium are an excellent choice), apples, crackers, ginger snap cookies or hard candies.

If you start to feel queasy, take the helm and steer the boat, focusing on the horizon. If the boat is overpowered, reduce sail. If you are close-hauled, ease sheets and fall off. If you must go below, take your foulies off in the cockpit and make a dash below. The faster you either get back on deck or lie down, the better you’ll feel. Lying down prevents histamine from reaching the brain, decreasing nausea. Have a 2 litre. bowl with tight-fitting lid handy in case you need to vomit. This is safer than hanging over the side of the boat to be sick. Don’t be afraid to vomit, you’ll feel better when you do.

Prolonged vomiting can cause dehydration (surprisingly quickly), dizziness, low blood sugar, low blood pressure, anxiety, confusion, depression and shock.

Treatment

Try anecdotal and non-prescription methods first, before prescription drugs.

Anecdotal remedies include ReliefBands, acupressure wrist bands, ginger and non-prescription formulas including Vitamin C, antihistamines and Stugeron. There is no one method or drug that works for everyone.

Vitamin C: Recent German research indicates that 1-3 grams disrupts histamine production. Emergen-C packets (available at health food stores) contain 1 gram Vitamin C, 31 mineral complexes plus fructose which acts as an electrolyte replacement, keeping blood sugar levels up. Drinking 1 litre with a packet two hours before and an hour after getting underway has proven to be effective for most people.

Antihistamines: Most antihistamines cause serious drowsiness making them inappropriate drugs for sailors needing to maintain an alert watch. To be effective, antihistamines should be taken the night before departure and again right before departure. Any oral tablets are difficult to keep down once vomiting has started.

Stugeron (cinnarizine 15 mg tablets) appears to be the most effective of any non-prescription drug. It is available over the counter in Australia and England, but may not be available or require a prescription in other countries.

CAUTION! With any drug, prescription or non-prescription, there are published side-effects. Do your research! If you have heart, blood pressure or prostate problems your physician may not be able to recommend certain drugs. Follow your doctor’s advice and try any anti-seasickness drug out on land well before departure to check for side effects.

Prescription Anti-Nausea Drugs

Compazine (prochlorperazine) in 10 or 25 mg. suppositories is the most effective prescription drug from our 30 years of research. Phenergan, a similar drug, does not work nearly as well. Suppositories are far superior to tablets once vomiting has started. This drug is used to treat anxiety as well as nausea, and since anxiety causes nausea in many instances, this is an important drug to have aboard. Compazine very  occasionally has side effects, do your research.

Zofran ODT (ondansetron hydrochloride) 4 mg wafers (preferable) or tablets appears to be very effective with minimal side effects. It has a 100% success record with our expedition members!

Scoplalamine available as Transderm Scop 1.5 mg patches has many side effects including hallucinations, psychosis, extreme drowsiness, blurred vision and anxiety; so many physicians will not prescribe it. We have found Zofran to be a far more effective drug without any noticeable side effects.For some sailors Transderm Scop patches can be very effective when no other drug is working, but we consider it a drug of last resort; first try it out on land.

To become an accomplished sailor, one of the disciplines you must master is seasickness response; if not for you, perhaps for your fellow crew members.

Some level of seasickness (often moderate queasiness) is normal and should be expected during the first 1-4 days of an ocean passage, even if you have never been seasick while coastal sailing.

You will need to stand your regular watches and join the crew at mealtime, even if seasick. This is very important for a speedy recovery. The incidence of sustained seasickness aboard Mahina Tiare, even in heavy weather has dropped to nearly zero for expedition members that have followed the above suggestions.

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